8 and 9 Biobehavior I and II Flashcards
What are the primary mechanisms to consider for any complaint of pain
- disease
- nociception
- the brain
What are the three fundemental concepts of pain
- Pain is not the same as nociception
- Chronic pain is not the same as acute pain
- pain= meaning
Describe the steps in modulation of nociception and sensitization
- peripheral nociception (block with LA)
- Spinal cord integration (block with pain meds)
- Central processing (i.e fear/distress)
- Pain experience
Examples of yellow flags for behaviors are
- EtOH and drug use
- Persistent Pain beliefs
- Work related issues
- Family and social related- overprotection from family members
- Chronicity of pain
- Functional limitation
- Discrepancy in findings
- Overuse of medication
- Inappropriate behavior
- Inappropriate expectations
- Inappropriate responsiveness to prior treatment
Red flag behaviors
- Suicidal- Refer immediately
- Persistent psychologic disturbance
- Psychiatric/medication issues
- Substance abuse
What are the advantages and disadvantages of interviewing patients
Advantages
- Adaptable
- Clinical experience
- Establish tx goals
- Severity judgements
Disadvantages
- time consuming
- requires high clinical skill
- bias
What are the advantages and disadvantages to questionaires
Advantage
- Little provider time
- Low skill needed
- Easy interpretation
- Facilitates screening
Disadvantages
- Language/reading issues
- May not apply
- May be too specific
- Scoring, missing values
Which is done first- questionaire or interview
questionaire (guides the interview)
What are the three different forms of assessment for Axis II (describe them)
- Brief screening- done on every patient looks at their pain and distress
- Screening- More at risk patients asks about pain, distress and functional jaw limitations
Comp- done by a specialist looks at everything + parafunction, co-morbid conditions, anxiety, depression, etc.
Graded chronic pain scale asks what about the patient’s pain
- Persistence
- Intensity
- How pain has interfered in their daily life
Jaw functional limitation scale asks what kinds of questions
- Mastication
- Jaw mobility
- Verbal and emotional expression
Revisit slide 52 of first lecture
ok- know the definitions
Describe the different stages of acute pain
- Stage I= initial distress
- Stage II= Development or exacerbation of behavioral issues
- Stage III= Consolidate illness behavior
Physical deconditioning and mental deconditioning take place when
Physical= up to stage II Mental= stages at stage I and progresses until stage III
Oain signals are increased by
- Fear, anxiety and uncertainty
- Negative mood
- Negative expectations
- Stress
- Past experience
- Setting and context
